Hepatocellular carcinoma (HCC) is a complex and heterogeneous tumor with various genomic alterations.In most patients,HCC is associated with cirrhosis which contributes to treatment morbidity and mortality.Cirrhosis adds difficulties to clinical management of HCC.Over the past decade,several molecular targets which are involved in the etiology of HCC have been identified.Among them,treatment with sorafenib,an antiangiogenic and Raf kinase inhibitor,has shown survival benefit.This represents a breakthrough in treatment of this complex disease,and proves that molecular therapies can be effective in HCC.It is becoming apparent that to overcome the complexity of genomic aberrations in HCC,combination therapies are essential.Several ongoing clinical trials show encouraging results.Future researches are necessary to identify new compounds to block important undruggable pathways,and to identify new oncogenes as targets for therapies through novel high throughout technologies.Ultimately,a molecular classification of HCC based on genome investigations and identification of patient subclasses using drug responsiveness will lead to a more personalized treatment.Although molecular therapy is a promising treatment for HCC with cirrhosis,surgery,if applicable,remains the first choice of treatment.

OBJECTIVE:To explore therapeutic efficacy and safety of Puerarin injection for elderly female patients with osteo-porosis and unstable angina pectoris,and its effects on serum inflammatory factors. METHODS:Totally 107 elderly women with osteoporosis and unstable angina were analyzed retrospectively and divided into control group(53 cases)and observation group(54 cases) according to drug use. Control group was given routine treatment as Caltrate D,Alendronate sodium tablet,Glyceryl trini-trate tablet ,Metoprolol tartrate tablet,Atorvastatin calcium tablet,Trimetazidine hydrochloride tablet. On the basis of control group, observation group was additionally given Puerarin injection 4 mL added into 5% Glucose injection 500 mL intravenously,once a day. Treatment course of 2 groups lasted for 2 weeks. Therapeutic efficacies of 2 groups were observed as well as the levels of se-rum inflammatory factors(hs-CRP,TNF-α,MMP-9,sCD40L),and the occurrence of ADR. RESULTS:The total response rates of angina pectoris and osteoporosis pain in observation group were significantly higher than control group,with statistical signifi-cance (P<0.05). Before treatment, there was no statistical significance in serum inflammatory factors as hs-CRP, TNF-α, MMP-9,sCD40L between 2 groups (P>0.05). After treatment,the levels of hs-CRP,TNF-α,MMP-9 and sCD40L in 2 groups were significantly lower than before,and the observation group was significantly lower than the control group,with statistical sig-nificance(P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:Based on routine treatment,Pu-erarin injection shows significant therapeutic efficacy for senile female osteoporosis patients with unstable angina and can significant-ly reduce the levels of serum inflammatory factors with good safety.

A total of 60 patients with an acute attack of asthma were studied.On presentation,fractional exhaled nitric oxide (FeNO) and the serum concentrations of procalcitonin (PCT) and C-reactive protein (CRP) were measured.And sputum culture was also performed.The patients were re-evaluated while returning to their clinical remission states.They were classified into 2 groups:patients with bacterial infection (group A) and those with nonbacterial infection (group B).The levels of FeNO were significantly higher in patients with acute exacerbation than those in remission.No difference existed between groups A and B ( P ＞ 0.05 ).The levels of PCT and CRP of group A with acute exacerbation were significantly higher than those of group B( all P ＜0.05).While in remission,the levels of PCT and CRP decreased significantly in group A ( P ＜ 0.05 ) ; But compared with exacerbation,the levels of PCT and CRP showed no change in group B (P ＞0.05).And no differences existed between two groups while in remission (P ＞ 0.05 ).An elevation of FeNO indicates the acute exacerbation of asthma.And the increased serum levels of PCT and CRP are associated with bacterial infection.

According to the characteristics of general surgery class teaching,methods and experiences of the application of associative approach to general surgery class teaching were analyzed,such as word,picture,contrast,comprehensive,analogical and association,which is advantageous to the improvement of class teaching methods,effects and students' study interests and ideation.

Traditionally,antigen presenting cells were shown to express MHC Ⅱ antigens.However,some researchers have demonstrated that a subset of T lymphocytes could express MHCⅡ antigens in some situation.Its regulatory mechanism and biological effects remains challenging to researchers.This review provides an overview of the results of these MHC Ⅱ + T lymphocytes regarding to the generation,mechanisms,and the role in immune tolerance induction,aim to provide some insights in clinical immune tolerance induction.

The long-term use of immunosuppressive agents after organ transplantation is associated with many undesirable side effects which may limit the survival of patients and transplanted organs.To patients and transplant surgeons,organ transplantation tolerance is the ultimate goal to improve patient's quality of life.The clinical state of allograft acceptance termed operational tolerance has remained infrequent in clinical transplantation because of the lack of validated assays or biomarkers predictive of tolerance and the concerns about the safety and ethics of complete withdrawal of immunosuppression.Despite these barriers,a number of investigators have continued to conduct well-designed studies with the long-term goal of inducing clinical transplantation tolerance.This review provides an overviewof the currently successful approaches to achieve clinical operational tolerance,including using immunosuppression slow withdrawal in organ transplantation,transplantation tolerance through mixed chimerism and clinical application of T regulatory cells in tolerance.

With the quick development of information network,a new disease-Internet Addiction has been paid more and more attention,and how to prevent and cure it has become one important problem that need to be resolved.At present,the rate of Internet Addiction among medical students is rising year by year,so we should make a united effort to prevent and control Internet Addiction among medical students.This article tries to explore how to prevent and control medical students'Internet Addiction from the point of view of law and ethics and expect to prevent them form being patients of Internet Addiction and help them thrive promptly.

This study explored the role of apoptosis of alveolar wall cells of chronic obstructive pulmonary disease (COPD) patients with pulmonary emphysema in the pathogenesis of emphysema. The subjects were divided into three groups: COPD patients with pulmonary emphysema (COPD group), asymptomatic smokers and non-smokers. Lung tissues were harvested and histologically assessed. TUNEL assay was employed to determine the apoptotic cells. The expression of PCNA, Bax and SP-C in the lung alveolar wall cells were immunohistochemically determined. SP-C immunofluorescence staining was used to identify type II alveolar cells in the TUNEL-positive cells. The mean linear interval (MLI), mean alveoli number (MAN) and mean alveoli area (MAA) in COPD group were significantly different as compared with those in asymptomatic smokers and non-smokers, respectively (P<0.01). The proliferation index (PI), apoptosis index (AI) and the percentage of Bax-positive cells in COPD group were significantly greater than those of asymptomatic smokers and non-smokers (P<0.01). However, the percentage of SP-C-positive cells was significantly lower in COPD group than in asymptomatic smokers and non-smokers (P<0.01). Most of the TUNEL-positive cells expressed SP-C. In COPD group, the apoptosis of alveolar wall cells, especially apoptosis of type-II cells, may take part in the pathogenesis of emphysema. Up-regulation of Bax expression may be responsible for the apoptosis of alveolar wall cells in the COPD patients with pulmonary emphysema.

BACKGROUND: Earthworms are one of the most important constituents in the ecosystem and become an environmental information carrier between terrestrial organisms and soil ecosystem. They were known as important non-target terrestrial soil organisms for assessing the general impact of pollution on the soil community. Protein content and growth rate in response to organic and heavy metal contaminants in soil are often used to assess the soil ecotoxicity.OBJECTIVES: To investigate the effects of 1, 8-dihydroxyanthraquinone,one representative of hydroxyanthraquinones, on the earthworm eisenia foetide under laboratory conditions of the growth rate and protein content.DESIGN: Experimental study based on the experimental animals.SETTING: Eco-toxicological laboratory and genetic laboratory in a university.MATERIALS: The experiment was conducted in the Eco-toxicological Laboratory and the Genetic Laboratory, Dalian University of Technology from February to July 2004. Eisenia foetide, a kind of international standard earthworm, were maintained in a soil mixture before experiments. Earthworms used in this study were healthy adults with 1 -2 month old and 200 - 300 mg mass and the number of the earthworms in each analytical experiment was 10.METHODS: The earthworms were removed from the soil 12 hours before use and stored in Petri dishes on damp filter paper to void gut contents.Then, these earthworms were exposed for various durations to soils contaminated. The earthworm weight and protein content were determined respectively at every 7 days interval.MAIN OUTCOME MEASURES: Effects of 1, 8-dihydroxyanthraquinone on growth rate and protein content of earthworms.RESULTS: No lethal effect of 1, 8-dihydroxyanthraquinone was observed even at the highest concentration(1.0 g/kg soil) of exposure. The sub-lethal effect, however, was evident at all the concentration scale. 1,8-dihydroxyanthraquinone caused a significant reduction in the growth rate (maximum -22. 5% ) at the dosage of 1.0 g/kg and 28 days contact time.Additionally a reduction in total soluble protein was observed in all treated worms(maximum- 39.6% ) at the dosage of 0. 8 g/kg and 7 days contact time.CONCLUSION: 1, 8-dihydroxyanthraquinone was potentially dangerous to the soil ecosystem and more ecological risk assessment of this chemical material should be thoroughly carried out.

Objective To evaluate the clinical value of laparoscopic cystogastrostomy for retrogastric pancreatic pseudocysts.Methods Five patients suffering from retrogastric pancreatic pseudocysts caused by severe acute biliary pancreatitis received conservative management for 2 ～ 6 months,and the sizes of pseudocysts were 8,10,12,14,15 cm.All the 5 patients received laparoscopic cystogastrostomy,and 4 ports methods was applied,through anterior gastric wall,the posterior gastric wall and pancreatic pseudocysts were incised by using harmonic scalpel,then cystogastrostomy was performed to drain the pseudocysts.Results Laparoscopic cystogastrostomy for retrogastric pancreatic pseudocysts was successful in all patients,theoperation time was 90,105,115,120,150 minutes.The blood loss was 100,150,150,200,300 ml.No intra-gastric bleeding occurred.After 1 month follow-up,all the pseudocysts disappeared,and there was no acute pancreatitis and local infection recurrence.Gastric leakage occurred 7 d after operation in one patient,and was healed after one month of conservative management.Conclusions Laparoscopic cystogastrostomy through gastric cavity for retrogastric pancreatic pseudocysts is simple and effective,mini-invasive,and it can be an alternative therapeutic method for pancreatic pseudocysts.